Know your rights: The Louisiana Infertility Mandate

louisiana

The Louisiana infertility mandate, enacted in 2002, makes it illegal to exclude coverage for a medical condition just because it results in infertility. It does not require coverage for fertility drugs, treatments or sterilization (getting vasectomy or tubes tied). This law is one of the weakest mandates as it doesn’t require coverage for infertility care. It simply states that insurance plans cannot exclude coverage for correctable medical conditions that result in infertility.

Further information is clarified in the Louisiana Insurance Code. A summary of eligibility requirements, exemptions and services covered is outlined below.

How the mandate defines infertility

It does not provide a definition of infertility.

 

Eligibility requirements

Patients that have a correctable medical condition cannot be denied treatment solely because treatment may result in infertility.

How the law treats male infertility

The law does not distinguish between male and female infertility, so presumably men are covered.

Services that are covered

No explicit services are called out as required to be covered.

Limitations on coverage

The law does not require coverage for fertility drugs, fertility treatments or sterilization procedures.

Exemptions

Self insured employers are exempt from the mandate.

Tips & Resources

The Louisiana mandate does little to ensure coverage of infertility care by insurance companies. This doesn’t mean that you don’t have coverage, but it does mean you are going to need to do some extra homework to understand what (if any) benefits are available to you. We’ve put together a primer article on how health insurance works and how to figure out what your benefits are likely to be.

Take advantage of other health benefits you may have: such as HSA/FSA accounts, preventative health services and wellness programs offered through your insurance. Getting healthy as possible can improve the health of your unborn child and potentially improve your chances of conceiving (naturally or with treatment).

Additional Resources: There are several organizations that support people who have trouble getting pregnant including Fertility within Reach (focused on helping people navigate insurance issues) and Resolve (that does both advocacy and peer-led patient support groups). You may also be able to connect with other people in your area via our local forum boards.

References:


Sara SDx

Sara SDx

Editor of Don't Cook your Balls, Co-Founder of TrakFertility.com, Health Coach and Men's Health Advocate. Passionate about sperm, men's health and helping people build their families.
Sara SDx

Author: Sara SDx

Editor of Don't Cook your Balls, Co-Founder of TrakFertility.com, Health Coach and Men's Health Advocate. Passionate about sperm, men's health and helping people build their families.